Effects of ultrasound of different intensities plus neurotrophic factors on inflammatory markers and oxidative stress, and clinical efficacy in patients with diabetic peripheral neuropathic pain

Objective: To evaluate the efficacy of different ultrasound intensities combined with neurotrophic factors (NTFs) in diabetic peripheral neuropathic pain (DPNP) patients, focusing on pain relief, inflammation, and oxidative stress. Methodology: In this retrospective study, a total of 180 patients with DPNP admitted to Affiliated Hospital of Hebei University from October 2022 to December 2023 were randomized into control (gabapentin), low-dose (L: 0.5–1.0 W/cm²), and medium-dose (M: 1.0–1.75 W/cm²) ultrasound groups, all receiving 20 mg/day ganglioside for 5 weeks. Outcomes included Visual Analog Scale (VAS) scores, inflammatory markers (TNF-α, CRP, IL-6), and oxidative stress markers (SOD, GSH-Px, TAC, CAT, GR). Results: The L group showed higher overall response rates (88.33%) versus M (73.33%) and control (53.33%) (P=0.000). VAS scores decreased most in L group (P=0.00). TNF-α, CRP, and IL-6 levels reduced significantly in L/M groups versus control (P<0.05), with no intergroup differences (P>0.05). SOD, GSH-Px, TAC, and CAT levels improved most in L group (P=0.00). GR levels showed no significant difference among these groups (P = 0.88). Conclusion: Low-dose ultrasound combined with NTFs significantly alleviates DPNP pain, reduces inflammation, and enhances antioxidant capacity, demonstrating superior clinical efficacy.